Supporting Media and Information Literacy
Searching for health information online has been compared to drinking water from a firehose, and users need help distinguishing between the credible and the problematic. A number of organizations and projects attempted to help the public by developing evaluation criteria for online information. Two most established criteria-based tools are HONcode and DISCERN.
HON, or Health on the Net Code, is run by a nonprofit foundation that awards criterion-based certification to health-related websites that apply for it. Certification suggests that a site meets the following eight criteria:
- - Authoritative - authors have satisfactory qualification in the subject matter
- - Complementarity - information intends to support, rather than replace relationship with healthcare providers
- - Privacy - the site respects privacy and confidentiality of users’ personal data
- - Attribution - sources of information are clearly cited
- - Justifiability - claims about benefits of treatments are backed by evidence
- - Transparency - the site is easy to comprehend and includes accurate contact information
- - Financial disclosure - the site’s funding sources are clearly stated
- - Advertising policy - advertisement is clearly differentiated from the rest of the content
HON Foundation website includes a specialized search engine that allows queries of HON -certified sites. In June 2019, the foundation counted over 7,300 websites from 102 countries among recipients of its certificate (Health on the Net Foundation [HON], 2019).
Unlike HON, DISCERN [http://www.discern.org.uk/], developed as a collaborative project between the UK National Health Service and the British Library in 1996-97, comprises a set of criteria for evaluating consumer health information. Its original purpose was to help individuals evaluate information about medical treatments, though it has since been applied to a broader range of documents. Unlike HON, DISCERN does not certify documents, but rather, helps users decide whether those documents fit specific quality criteria. Users evaluate whether the publication is reliable and whether the treatment information it presents is of high quality. Reliability criterion considers factors such as clear aims, relevance, clarity of sources, absence of bias, and statement of uncertainty. Information quality criterion considers whether treatment mechanism and risks and benefits are discussed, whether alternative treatment options are described, and whether the document supports shared decision-making with health professionals and family members. Ultimately, the user rates the document on a scale from 1 (serious or extensive shortcomings) to 5 (minimal shortcomings).
While DISCERN supports more in-depth analysis of a document’s quality, it leaves the judgment to subjective analysis by the user. In addition, it was developed for print documents and may not constitute the best fit for the contemporary digital information ecosystem that includes videos and social media posts (Keselman, Arnott Smith, Murcko, & Kaufman, 2019). Consumer health informatics can help by developing information quality evaluation criteria tailored to web media and by creating algorithms for evaluating information quality. In the meantime, developers can help users by following HON and DISCERN recommended criteria, by being aware of HON and other emergent certification systems, and by considering obtaining these certifications (for more discussion about the evaluation of health information and the role of tools like these, refer to Part I: Chapter 5).